Physicians Want to Learn From Medical Mistakes But Say Current Error-Reporting Systems are Inadequate

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ROCKVILLE, Md., Jan. 9 /PRNewswire-USNewswire/ -- The perception that
U.S. doctors are unwilling to report medical errors and learn how to
prevent them is untrue, according to a new study funded by HHS' Agency for
Healthcare Research and Quality (AHRQ).

Because most doctors think that current systems to report and share
information about errors are inadequate, they rely instead on informal
discussions with their colleagues. Consequently, important information
about medical errors and how to prevent them often is not shared with the
hospital or the health care organization, according to the study, which
appears in the January/February issue of Health Affairs. As a result, such
information is not aggregated for analysis and systematic improvement.

"These findings shed light on an important question - how to create
error-reporting programs that will encourage clinician participation," said
AHRQ Director Carolyn M. Clancy, M.D. "Physicians say they want to learn
from errors that take place in their institution to improve patient safety.
We need to build on that willingness with error-reporting programs that
encourage their participation."

To assess physicians' attitudes about communicating errors with their
colleagues and health care organizations, the study authors used a
68-question survey to poll a geographically diverse group of more than
1,000 physicians and surgeons currently practicing in rural and urban areas
in Missouri and Washington State. The survey was conducted between July
2003 and March 2004.

Doctors were asked about their attitudes toward and experience with
communicating about errors with both their health care organizations and
their colleagues. Most physicians reported that they had been involved in
an error -- 56 percent reported a prior involvement with a serious error,
74 percent with a minor error and 66 percent with a near miss. More than
half (54 percent) agreed with the statement that "medical errors are
usually caused by failures of care delivery systems, not failures of
individuals."

The majority of physicians agreed that they should report errors to
their hospital or health care organization to improve patient safety.
Almost all (95 percent) physicians agreed that they needed to know about
errors in their organization to improve patient safety, and 89 percent
agreed that they should discuss errors with their colleagues.

Eighty-three percent said they had used at least one formal reporting
mechanism, most commonly reporting an error to risk management (68 percent)
or completing an incident report (60 percent). Few physicians believed that
they had access to a reporting system that was designed to improve patient
safety, and nearly half (45 percent) did not know if one existed at their
organization.

Most physicians (61 percent) had used at least one informal mechanism
to report an error to their hospital or health care organization, most
commonly telling a supervisor or manager (40 percent) or physician chief or
departmental chairman (38 percent). Physicians were more likely to discuss
serious errors, minor errors and near misses with their colleagues than to
report them to a risk management or to a patient safety official.

Only 30 percent agreed that current systems to report patient safety
events were adequate. When asked what would increase their willingness to
formally report error information, physicians said they wanted: 1)
information to be kept confidential and non-discoverable (88 percent); 2)
evidence that such information would be used for system improvements (85
percent) and not for punitive action (84 percent); 3) the error-reporting
process to take less than 2 minutes (66 percent); and 4) the review
activities to be confined to their department (53 percent).

The U.S. Department of Health and Human Services is currently
developing proposed regulations to implement the Patient Safety and Quality
Improvement Act of 2005 (the Patient Safety Act). The Patient Safety Act
authorizes the creation of new entities called Patient Safety Organizations
(PSOs) that will collect, aggregate and analyze confidential information
voluntarily reported by health care providers; such information is
generally confidential and privileged in accordance with the Patient Safety
Act. PSOs will use this information to identify systemic and avoidable
causes of risk in medical settings and to provide feedback to health care
providers about successful approaches that reduce such risk and thereby
improve patient safety and quality.

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